J Intern Med. 2017 Dec 6. doi: 10.1111/joim.12718. [Epub ahead of print]

Clinical Implications of Bone Marrow Adiposity.

Veldhuis-Vlug AG^1,2, Rosen CJ².

Abstract

Marrow adipocytes, collectively termed marrow adipose tissue (MAT), reside in the bone marrow in close contact to bone cells and hematopoietic cells. Marrow adipocytes arise from the mesenchymal stem cell and share their origin with the osteoblastst. Shifts in the lineage allocation of the mesenchymal stromal cell could potentially explain the association between increased MAT and increased fracture risk in diseases such as postmenopausal osteoporosis, anorexia nervosa and diabetes. Functionally, marrow adipocytes secrete adipokines, such as adiponectin, and cytokines, such as RANK-ligand and stem cell factor. These mediators can influence both bone remodeling and hematopoiesis by promoting bone resorption and hematopoietic recovery following chemotherapy. In addition, marrow adipocytes can secrete free fatty acids, acting as a energy supply for bone and hematopoietic cells. However, this induced lipolysis is also used by neoplastic cells to promote survival and proliferation. Therefore, MAT could represent a new therapeutic target for multiple diseases from osteoporosis to leukemia, although the exaxt characteristics and role of the marrow adipocyte in health and diseases remains to be determined. This article is protected by copyright. All rights reserved.